Here's the short version. Medicare does cover cataract surgery. Part B may cover cataract surgery that implants a conventional (standard) intraocular lens. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount. Medicare usually does not pay for glasses. But there is one exception: Part B covers one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants a lens. Upgraded frames or lenses cost extra. The rest of this page explains the details.
What cataract surgery is, and what Part B covers
Cataract surgery removes a cloudy natural lens from your eye. In most cases, the surgeon replaces it with a clear artificial lens. This artificial lens is called an intraocular lens. Medicare Part B may cover the surgery when it implants a conventional intraocular lens, depending on where you live.
"Conventional" is the key word. Medicare's coverage is built around the standard lens. Your doctor may recommend a different kind of lens or extra services that Medicare does not cover. That can leave you with added costs. Before surgery, ask your doctor why they recommend each item and what Medicare will actually pay for.
What you pay for the surgery
Your share depends on where you have the surgery.
- Hospital outpatient department or ambulatory surgical center. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount to the facility and 20% to the doctor who performs your surgery.
- Doctor's office. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for both the intraocular lens and the surgery to implant it.
The exact amount you owe also depends on other insurance you have, how much your doctor charges, whether your doctor accepts assignment, and the type of facility. Ask your doctor or the facility how much your surgery will cost before you schedule it. Our costs guide explains deductibles, coinsurance, and assignment in plain terms.
Glasses after cataract surgery
Medicare doesn't usually cover eyeglasses or contact lenses. Cataract surgery is the exception. Part B covers one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an intraocular lens. "After each surgery" matters. If you have surgery on one eye now and the other eye later, each surgery comes with its own pair.
Here is what you pay for the glasses:
- After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for corrective lenses after each covered cataract surgery.
- You pay any additional cost for upgraded frames.
- Medicare will only pay for glasses or contacts from a supplier that participates in Medicare. That is true whether you or your provider submits the claim. Ask the optical shop whether it participates in Medicare before you order.
What Medicare doesn't cover for your eyes
Medicare doesn't cover routine eye exams for eyeglasses or contact lenses. These are sometimes called eye refractions. You pay all costs for them. Once you have your one covered pair after surgery, later glasses are on you too. Some Medicare Advantage plans offer extra vision benefits that Original Medicare doesn't cover. Contact the plan for details. Our guide to dental, vision, and hearing coverage walks through those options.
Medicare Advantage and Medigap
If you have a Medicare Advantage plan, your plan covers cataract surgery too. Your copays, your choice of surgeon, and any prior approval rules are set by the plan. Call the plan before you schedule surgery and ask what you'll owe. If you have Original Medicare with a Medigap policy, the policy may pay some or all of your 20% share, depending on which plan you have.
Common questions
Does Medicare pay for premium or multifocal lenses?
Medicare's coverage is for cataract surgery that implants a conventional intraocular lens. If your doctor recommends a lens or service that Medicare doesn't cover, you could face added costs. Ask your doctor to explain the reasons and what Medicare will actually cover.
Do I get glasses for both eyes if I have two surgeries?
Part B covers one pair of glasses with standard frames, or one set of contacts, after each cataract surgery that implants an intraocular lens. So two surgeries means two covered pairs, each with your 20% share after the deductible.
Can I pick any optical shop for my glasses?
No. Medicare will only pay for eyeglasses or contact lenses from a supplier that participates in Medicare. Ask before you order, or you could end up paying the full price.
Why did I get two bills for my surgery?
In a hospital outpatient setting or surgery center, you pay 20% of the Medicare-approved amount to the facility and 20% to the doctor who performs the surgery. Those are two separate bills for one procedure.
Related pages
- Does Medicare Cover Dental, Vision, and Hearing? — the routine care Medicare leaves out, and how people fill the gap.
- Medicare Part B — what medical insurance covers and how assignment works.
- Understanding Your Costs — deductibles, coinsurance, and how bills add up.
- Medicare Diabetes Coverage — includes the yearly eye exam Medicare covers for people with diabetes.
Official sources: Medicare.gov: Cataract surgery, Medicare.gov: Eyeglasses & contact lenses, and Medicare.gov: Eye exams (routine).